Physiotherapists in Harpenden treat many different conditions including the issues profiled below.

Lumbar Stenosis

There are many painful syndromes which involve the lumbar spine, with the discs, ligaments, joints, muscles and nerves all implicated in pain production. Older people can present with symptoms which indicate a stenosis of their vertebral canal. The vertebral or spinal canal runs down the back and carries the spinal cord, allowing the nerve roots to exit to the body at each spinal level (each disc level). The spinal canal can be congenitally narrow which increases the chances of developing spinal stenosis with age. As degenerative changes occur in the spinal structures the spinal canal can become narrowed and tight.

The symptoms of spinal stenosis typically do not include back pain but rather leg pain, often bilateral, and worsened by walking but better with sitting. Typically presenting in people of 65 years or older, spinal stenosis can also present as a nerve root irritation of a sciatic type due to stenosis of the exit for the spinal nerve root. Physiotherapy is not usually very useful and little is found on examination apart from a reduction in spinal extension and many people manage their symptoms over time as best they can, although surgical spinal decompression can be very successful in relieving the symptoms.

Bunions

Bunions is the term given to problems which occur with the joint of the big toe as it meets the foot, the first metatarsophalangeal joint or MTP joint. Problems with this joint may be familial with some inherited tendency but can also be do to poor foot use such as ill fitting footwear. Signs may start with an increased prominence at the inner border of the foot as the big toe drifts slightly towards the outside of the foot, eventually leading to rubbing of the prominence on the shoe in walking. Progression may occur as the deformity becomes worse and the joint itself becomes painful, with the big toe compressing the second toe and perhaps overriding or under riding it.

A highly arthritic joint can be very disabling, severely restrict the ability to walk very far and cause huge problems in choosing suitable footwear. Initial physiotherapy treatment can be provision of insoles, mobilisation techniques, gait correction, provision of walking aids and moderation of aggravating activities. More severe problems can be treated by joint injection, shaving of the joint surgically, removal of the joint to leave a fibrous union, fusion of the joint (arthrodesis) or replacement of the joint with a prosthesis.